12
Gastroparesis
• Nutritional Supplements such as:
o Carnation Breakfast Anytime
o Boost
o Boost Diabetic
o Boost Fruit Beverage
o Boost High Protein
o
o
o
o
o
Boost Plus Calories
Ensure
Ensure High Protein
Ensure Plus
Glucerna
How can I puree or “blenderize” my foods?
Pureed foods can sometimes be easier for your body to digest. Refer to the
HHS “Pureed Diet” handout to learn about how to blenderize your foods.
Gastroparesis
What is gastroparesis (gas-tro-pear-ee-sis)?
Sample diet
The following is a sample diet for someone who is following stage 3
of the Gastroparesis Diet.
• Breakfast: 1 cup cream of wheat, 1 slice white toast and 1 tablespoon
peanut butter, ½ cup skim milk, ½ cup juice
• Snack: 6 ounces low fat yogurt and ½ banana or 1 cup nutritional
supplement
• Lunch: 1 cup pasta, 1 tablespoon fat-free parmesan cheese and
1 tablespoon low fat margarine, ½ cup applesauce, ½ cup skim milk
or 4 ounces nutritional supplement
Or
½ turkey sandwich with 1 Tbsp low fat mayonnaise with ½ cup
chicken noodle soup, ½ cup applesauce, ½ cup skim milk
• Snack: ½ cup canned peaches and ¼ cup low-fat cottage cheese
Or
smoothie with ½ cup Gatorade or carbonated beverage
• Dinner: 2 ounces skinless chicken or fish, ½ cup cooked squash
and ½ cup cooked mashed potatoes with no skin, 1 tsp butter,
½ cup skim milk, ½ cup canned peaches
• Snack: 1 cup low-fat pudding or frozen yogurt, ½ cup carbonated
beverage
• Liquids: vegetable juice, crystal light, water, fruit juice, skim or
1% milk
©
Hamilton Health Sciences, 2013
PD 8364 – 11/2013
dpc/pted/Gastroparesis-trh.doc
dt/November 12, 2013
Gastroparesis is a condition where food moves through your stomach
slower than normal and takes longer to digest (breakdown).
What causes gastroparesis?
The cause of gastroparesis is not always clear, but it is believed that
there might be damage to a nerve that controls stomach muscles.
It can occur suddenly or as a result of:
• diabetes
• stomach surgery or nerve injury such as after bariatric gastric
surgery
• medications, such as narcotics
o ask your doctor if any of your medications slow down
stomach emptying
• nervous system diseases like Parkinson’s Disease,
Multiple Sclerosis, or Amyotrophic Lateral Sclerosis (ALS)
• infection, such as viral gastroenteritis
• certain cancer treatments
• collagen vascular disorders such as scleroderma
• lupus
• hypothyroidism
• gastroesophageal reflux disease
____________________________________________________________________________
2
Gastroparesis
What are the symptoms of gastroparesis?
Your symptoms may include:
•
•
•
•
•
a feeling of fullness after a few bites
belching or burping
bloating or abdominal distension
nausea and vomiting
food or fluid from the stomach moving back into your mouth
– this is called regurgitation or heartburn
• decreased appetite which may lead to weight loss and poor
nutrition
• constipation
Food Group
Beverages
Soups
Sweets
Other
If you have diabetes, you may also have abnormal sugar (glucose)
levels in your blood.
What are the complications of gastroparesis?
Complications of gastroparesis could include:
•
•
•
•
•
•
•
•
weight loss
abdominal discomfort
bacterial overgrowth
food that stays in the stomach too long can start to ferment,
causing bacteria to grow
bezoar
o A bezoar is a mixture of food residues/materials that can
accumulate or build up in the stomach and does not
empty well. A bezoar can block food from going into the
small intestine.
blood sugar fluctuations
o For people with diabetes, blood sugars may be harder to
control as food is digested at inconsistent times.
dehydration (not enough fluid in your body)
electrolyte imbalance
__________________________________________________________________________________
11
Gastroparesis
Recommended Items
Gatorade/soft drinks (small
amounts at a time)
Flavoured coffee
Tea
Hot chocolate
Water, lemonade, Kool-Aid
Nutritional supplements
Same as Stage 2 plus all soups
made with all milks
Same as Stage 2 plus:
Angel food cake
Low fat cookies such as
arrowroot, social tea, graham
crackers
Same as Stage 2
Items to Avoid
Alcohol
All others not listed in
recommended items
Soups made with cream
Broths containing fat
Same as Stage 2
What do I do if my symptoms get worse?
• Try drinking nutritional supplements and pureed foods before you
take liquids with small amounts of nutrients, like coffee, tea and pop.
• On days when your symptoms are worse, rest your stomach by taking
fluids or pureed foods only (this does not have to be as strict as
stage 1 of the gastroparesis diet, see list below). Small portions
(around 1 cup) or having sips through out the day may help you to
better tolerate them.
List of fluids and pureed foods:
• Broth, cream or pureed soups
• Juice (apple, cranberry, grape, prune)
• Sprite, gingerale
• Tomato juice/V8
• Milk
• Eggnog
• Kefir
• Yogurt
• Milkshakes, pudding, smoothies and custards
• Baby food
• Oral rehydration solutions, such as: Gastrolyte or Pedialyte
• Powerade/Gatorade
please turn over 
________________________________________________________________________________
10
Gastroparesis
Food Group
Recommended Items
Gastroparesis
Items to Avoid
Vegetables
Same as Stage 2
Same as Stage 2
Fruits
Peeled fresh fruit such as
banana, apple, pear, peaches,
plums, melons
Apple/cranberry/grape/prune
juice
Canned fruits without skins
(applesauce, peaches, pears,
apricots, mandarin oranges)
All fruits and juices not listed in
items to avoid
Fruits with skins, seeds and
membranes such as: berries,
pineapple, grapes, oranges,
pomegranates
Dried fruit such as coconut, figs,
raisins, prunes, cranberries,
apricots, currants, dates
Citrus juices with pulp
Canned fruits with skin such as
cherries
Avocado
Same as Stage 2
Grains and
Starches
Same as Stage 2
Egg and ramen noodles
Meat and
Alternatives
Eggs/egg whites
Smooth peanut butter (maximum
2 tablespoons a day)
Poultry with no skin
Fish, shellfish
Lean beef
Pork
Low fat deli meats
Extra lean ground beef
Lean ground chicken/turkey
Canned fish in water
Low fat deli meats
Preparation: bake, broil, poach,
BBQ
Fats and Oils
Any type of fat but in small
quantities
Spray oils
Fat free gravy
Low fat mayonnaise
Fibrous meats
Steaks
Roasts
Bacon
Sausage
Bologna, salami
Hot dogs
Goose
Duck
Spare ribs
Organ meats
Fish packed in oil
Crunchy peanut butter
Dried beans and peas
Lentils
Nuts and seeds
European frankfurters and other
deli-made wieners/sausages with
tough casings
Deep fried meats
None
__________________________________________________________________________________
3
How is gastroparesis treated?
• Taking medication to help:
o Food move through your stomach
o Reduce nausea and vomiting
• Changing your diet to help improve your symptoms and prevent
poor nutrition.
• Controlling your blood sugar levels if you have diabetes.
What diet and lifestyle changes can I make to help control
my symptoms?
To help improve your symptoms of gastroparesis:
• Eat 6 or more small meals a day. Larger meals take longer to
digest and can make you feel full very quickly
• Chew foods well. This helps your stomach digest food better.
Avoid foods that are not easily chewed such as broccoli, corn,
popcorn, nuts and seeds.
• Eat healthy foods first. Choose foods with lots of nutrients
before filling up on “empty calories” such as tea, coffee, water,
pop and candies.
• Avoid lying down after a meal. Stay sitting up for at least one
hour after your meal. Going for a walk after your meal can also
help the food move through your stomach faster.
• Choose foods that are lower in fibre. Fibre is not digested and
can stay in the stomach longer, slowing digestion. Fibre can also
make you feel more full, making it difficult to eat enough food to
get all of the nutrients you need. Cooking fruits and vegetables
until soft can help you to digest them.
________________________________________________________________________________
4
Gastroparesis
What diet and lifestyle changes can I make to help control
my symptoms? (continued)
• Choose foods that are lower in fat. Foods that are high in fat
take longer to digest. Although fat may slow stomach emptying in
some people, many can tolerate fat in the liquid form, such as fat in
whole milk, milkshakes, smoothies and nutritional supplements.
Avoid all fried, fatty or greasy foods.
• Change the texture of your food. Liquids empty from the
stomach faster and more easily than solids. If you cannot tolerate
solid foods, then you may need minced, pureed or liquefied foods.
Your dietitian will discuss the texture that is right for you.
9
Gastroparesis
Food Group
Beverages
Soups
Sweets
• Limit your intake of alcohol. Alcohol can result in delayed
emptying of food out of the stomach.
Recommended
Gatorade/carbonated beverages
(small amounts at a time)
Nutritional supplements
Lemonade, Kool-Aid
Fat-free bouillon
Soups made with skim milk
Fat free soups made with
pasta/noodles
Strained/pureed cream soups
Hard candies, gummy candies,
jelly beans, marshmallows,
caramels
Puddings and custards made
with 1% MF or skim milk
Frozen yogurt
Fruit ice/sorbets/sherbet
Gelatin
Ice milk
Seedless jams and jellies Honey,
syrups
Mustard, ketchup, vinegar, soy
sauce, teriyaki sauce, hot sauce,
barbeque sauce
Avoid
Alcohol
All others, except allowed juices
Soups made from milk, cream, or
broths containing fat
High-fat desserts (cakes, pies,
cookies, pastries, ice cream)
Cookies with nuts/dry fruit
• If you have diabetes, keep your blood sugar under control.
Uncontrolled blood sugars can change how your stomach
empties food.
Other
• Talk to your doctor or pharmacist about your medications.
Some medications can slow stomach emptying while others can
help to improve your symptoms.
Stage 3: Solid foods low in fat and fibre. Allows you to have a little more
fat than Stage 2, and also limits foods containing a lot of fibre.
Food Group
Milk and
Alternatives
__________________________________________________________________________________
Recommended
Same as Stage 2 plus:
2% MF, homogenized and
chocolate milk
Regular soy, rice, almond milk
Milkshakes
Eggnog
Smoothies
Kefir
Buttermilk
1% or 2% MF cottage cheese
Ice cream
Fat free or 5% MF sour cream
Evaporated milk (0 to 2% MF)
Avoid
Regular cheese with >20% MF
Regular sour cream
Whipping cream (10 or 18% MF)
________________________________________________________________________________
8
Gastroparesis
Food Group
Grains and
Starches
Meat and
Alternatives
Fats and Oils
Gastroparesis
Recommended
Avoid
White breads and rolls
Refined cereals such as cream of
wheat and Rice Krispies,
Cheerios, Special K
White pasta
White rice and barley
Low-fat crackers such as soda
crackers
Pretzels
Oatmeal
High-fibre (over 5g fibre per
serving), whole-grain breads and
cereals
Cereals containing nuts, seeds,
coconut, dried fruits, granola mix
Whole grain pasta
Whole grain, brown and wild rice
Tea biscuits
Waffles, pancakes
Sweet rolls
Croissants
Donuts
Muffins
Egg noodles
Beef
Poultry
Fish
Pork, bacon
Legumes/dried beans such as
chick peas, kidney beans and
lentils
Nuts and seeds
Fibrous meats
Sausage
Bologna, salami
Hot dogs
Goose
Duck
Spare ribs
Organ meats
Fish packed in oil
Crunchy peanut butter
European frankfurters and other
deli-made wieners/sausages with
tough casings
Deep fried meats
None
Eggs/egg whites
Low fat egg substitutes
Smooth low fat peanut butter
(maximum 2 tablespoons a day)
Any type of fat but in small
quantities, limit to 3 tsp a day
Fat free salad dressing
Fat free gravy
__________________________________________________________________________________
5
What are some foods and medications I may want to avoid?
In general, you may want to avoid foods and medications high in fibre.
Avoiding seeds, skins and membranes of fruits and vegetables,
such as removing the skin from an apple or having applesauce,
will decrease your fibre intake. Also, cooking vegetables well,
until they are soft, will also make them easier to digest.
Foods high in fibre:
• legumes/dried beans such as chick peas, kidney beans
and lentils
• high fibre breads and cereals
• nuts and seeds
• dried fruits
• popcorn
• raw fruits, like berries
• raw vegetables
• high fibre vegetables such as corn, peas, broccoli,
brussel sprouts and cabbage
Medications high in fibre:
• fibre supplements including Metamucil, Benefibre and Prodiem
If you are told that you have a bezoar:
• Avoid foods that may cause a bezoar, such as figs, raisins,
berries, apples, coconuts, persimmons, brussel sprouts,
green beans, corn, legumes, potato skins, tomato skins,
seeds and sauerkraut.
• Avoid high fibre medications listed above.
________________________________________________________________________________
6
Gastroparesis
Stages of the Gastroparesis Diet
The Gastroparesis Diet will help you get enough nutrition and fluids
when you are finding it hard to eat enough food. The diet consists of
3 stages:
Stage 1 - Liquids. Liquids leave the stomach quickly and prevent
dehydration. Liquids can also provide you with salts and minerals that
you need. You can follow this stage when you are nauseous and
vomiting.
Stage 2 – Mostly liquids and soft foods low in fat and fibre. Follow this
diet when you are not vomiting. It includes a small amount of dietary fat.
Fatty foods and oils should be avoided because they slow stomach
emptying. Slowly introduce fats and track your body’s response.
Food Group
Recommended Items
None
All
Vegetables
None
All
Fruits
Apple juice
Grape juice
Cranberry juice
All
Grain and Starches
Saltine crackers
All others
Meat and Alternatives
None
All
Fats and Oils
None
All
Beverages
Sports drinks (Gatorade,
Powerade) and carbonated
beverages (small amounts
at a time)
Boost Fruit beverage
Fruit flavoured drinks
Plain Tea, coffee
All others
Soups
Fat free bouillon
All others
Other/desserts
Flavoured gelatins such as
Jello
Popsicles
__________________________________________________________________________________
Avoid
Skim or 1% milk fat (MF) milk.
Low fat soy milk, rice milk,
almond milk
Low-fat yogurt (0 to 2% MF fat)
Frozen yogurt
Low fat/fat free cottage cheese
Fat free sour cream
Buttermilk
Evaporated milk (0 to 1% MF)
Low fat cheeses with less than
15% MF in small amounts
Homogenized or 2% MF milk
Regular soy milk
Regular yogurt
Ice cream
Sour cream
Cottage cheese with 2% MF or
more
Regular/full fat cheese products
with 20% MF or more
Vegetables
Vegetable juice
Well cooked soft vegetables
(cauliflower, eggplant without
skin, parsnips, rutabagas, turnip,
bottled roasted red peppers,
squash, beets, carrots, potatoes
without skin, yams, mushrooms)
Smooth tomato sauce
Fruits
Apple juice
Cranberry juice
Grape juice
Prune juice
Canned fruits without skins
(applesauce, peaches, pears,
apricots, mandarin oranges)
All raw vegetables
Cooked vegetables with skins
such as bean sprouts, beans such
as green, wax and lima, peas,
peppers, tomato seeds and skins,
corn
Stringy vegetables such as
cabbage, sauerkraut, Brussels
sprouts, celery, fiddleheads,
sugar snap peas, okra, spinach,
kale, swiss chard, bok choy,
bamboo sprouts
Fried vegetables
Creamed vegetables
Coleslaw
Popcorn
Olives
Citrus juices with pulp
All fresh and dried fruits
Canned fruits with skin
Items to Avoid
Milk and Alternatives
Recommended
Milk and
Alternatives
• Only follow Stage 1 for 2 to 3 days, as it will not meet all of your
nutritional needs. Contact your doctor if you think you need to be at
this stage for longer.
Food Group
7
Gastroparesis
________________________________________________________________________________
6
Gastroparesis
Stages of the Gastroparesis Diet
The Gastroparesis Diet will help you get enough nutrition and fluids
when you are finding it hard to eat enough food. The diet consists of
3 stages:
Stage 1 - Liquids. Liquids leave the stomach quickly and prevent
dehydration. Liquids can also provide you with salts and minerals that
you need. You can follow this stage when you are nauseous and
vomiting.
Stage 2 – Mostly liquids and soft foods low in fat and fibre. Follow this
diet when you are not vomiting. It includes a small amount of dietary fat.
Fatty foods and oils should be avoided because they slow stomach
emptying. Slowly introduce fats and track your body’s response.
Food Group
Recommended Items
None
All
Vegetables
None
All
Fruits
Apple juice
Grape juice
Cranberry juice
All
Grain and Starches
Saltine crackers
All others
Meat and Alternatives
None
All
Fats and Oils
None
All
Beverages
Sports drinks (Gatorade,
Powerade) and carbonated
beverages (small amounts
at a time)
Boost Fruit beverage
Fruit flavoured drinks
Plain Tea, coffee
All others
Soups
Fat free bouillon
All others
Other/desserts
Flavoured gelatins such as
Jello
Popsicles
__________________________________________________________________________________
Avoid
Skim or 1% milk fat (MF) milk.
Low fat soy milk, rice milk,
almond milk
Low-fat yogurt (0 to 2% MF fat)
Frozen yogurt
Low fat/fat free cottage cheese
Fat free sour cream
Buttermilk
Evaporated milk (0 to 1% MF)
Low fat cheeses with less than
15% MF in small amounts
Homogenized or 2% MF milk
Regular soy milk
Regular yogurt
Ice cream
Sour cream
Cottage cheese with 2% MF or
more
Regular/full fat cheese products
with 20% MF or more
Vegetables
Vegetable juice
Well cooked soft vegetables
(cauliflower, eggplant without
skin, parsnips, rutabagas, turnip,
bottled roasted red peppers,
squash, beets, carrots, potatoes
without skin, yams, mushrooms)
Smooth tomato sauce
Fruits
Apple juice
Cranberry juice
Grape juice
Prune juice
Canned fruits without skins
(applesauce, peaches, pears,
apricots, mandarin oranges)
All raw vegetables
Cooked vegetables with skins
such as bean sprouts, beans such
as green, wax and lima, peas,
peppers, tomato seeds and skins,
corn
Stringy vegetables such as
cabbage, sauerkraut, Brussels
sprouts, celery, fiddleheads,
sugar snap peas, okra, spinach,
kale, swiss chard, bok choy,
bamboo sprouts
Fried vegetables
Creamed vegetables
Coleslaw
Popcorn
Olives
Citrus juices with pulp
All fresh and dried fruits
Canned fruits with skin
Items to Avoid
Milk and Alternatives
Recommended
Milk and
Alternatives
• Only follow Stage 1 for 2 to 3 days, as it will not meet all of your
nutritional needs. Contact your doctor if you think you need to be at
this stage for longer.
Food Group
7
Gastroparesis
________________________________________________________________________________
8
Gastroparesis
Food Group
Grains and
Starches
Meat and
Alternatives
Fats and Oils
Gastroparesis
Recommended
Avoid
White breads and rolls
Refined cereals such as cream of
wheat and Rice Krispies,
Cheerios, Special K
White pasta
White rice and barley
Low-fat crackers such as soda
crackers
Pretzels
Oatmeal
High-fibre (over 5g fibre per
serving), whole-grain breads and
cereals
Cereals containing nuts, seeds,
coconut, dried fruits, granola mix
Whole grain pasta
Whole grain, brown and wild rice
Tea biscuits
Waffles, pancakes
Sweet rolls
Croissants
Donuts
Muffins
Egg noodles
Beef
Poultry
Fish
Pork, bacon
Legumes/dried beans such as
chick peas, kidney beans and
lentils
Nuts and seeds
Fibrous meats
Sausage
Bologna, salami
Hot dogs
Goose
Duck
Spare ribs
Organ meats
Fish packed in oil
Crunchy peanut butter
European frankfurters and other
deli-made wieners/sausages with
tough casings
Deep fried meats
None
Eggs/egg whites
Low fat egg substitutes
Smooth low fat peanut butter
(maximum 2 tablespoons a day)
Any type of fat but in small
quantities, limit to 3 tsp a day
Fat free salad dressing
Fat free gravy
__________________________________________________________________________________
5
What are some foods and medications I may want to avoid?
In general, you may want to avoid foods and medications high in fibre.
Avoiding seeds, skins and membranes of fruits and vegetables,
such as removing the skin from an apple or having applesauce,
will decrease your fibre intake. Also, cooking vegetables well,
until they are soft, will also make them easier to digest.
Foods high in fibre:
• legumes/dried beans such as chick peas, kidney beans
and lentils
• high fibre breads and cereals
• nuts and seeds
• dried fruits
• popcorn
• raw fruits, like berries
• raw vegetables
• high fibre vegetables such as corn, peas, broccoli,
brussel sprouts and cabbage
Medications high in fibre:
• fibre supplements including Metamucil, Benefibre and Prodiem
If you are told that you have a bezoar:
• Avoid foods that may cause a bezoar, such as figs, raisins,
berries, apples, coconuts, persimmons, brussel sprouts,
green beans, corn, legumes, potato skins, tomato skins,
seeds and sauerkraut.
• Avoid high fibre medications listed above.
________________________________________________________________________________
4
Gastroparesis
What diet and lifestyle changes can I make to help control
my symptoms? (continued)
• Choose foods that are lower in fat. Foods that are high in fat
take longer to digest. Although fat may slow stomach emptying in
some people, many can tolerate fat in the liquid form, such as fat in
whole milk, milkshakes, smoothies and nutritional supplements.
Avoid all fried, fatty or greasy foods.
• Change the texture of your food. Liquids empty from the
stomach faster and more easily than solids. If you cannot tolerate
solid foods, then you may need minced, pureed or liquefied foods.
Your dietitian will discuss the texture that is right for you.
9
Gastroparesis
Food Group
Beverages
Soups
Sweets
• Limit your intake of alcohol. Alcohol can result in delayed
emptying of food out of the stomach.
Recommended
Gatorade/carbonated beverages
(small amounts at a time)
Nutritional supplements
Lemonade, Kool-Aid
Fat-free bouillon
Soups made with skim milk
Fat free soups made with
pasta/noodles
Strained/pureed cream soups
Hard candies, gummy candies,
jelly beans, marshmallows,
caramels
Puddings and custards made
with 1% MF or skim milk
Frozen yogurt
Fruit ice/sorbets/sherbet
Gelatin
Ice milk
Seedless jams and jellies Honey,
syrups
Mustard, ketchup, vinegar, soy
sauce, teriyaki sauce, hot sauce,
barbeque sauce
Avoid
Alcohol
All others, except allowed juices
Soups made from milk, cream, or
broths containing fat
High-fat desserts (cakes, pies,
cookies, pastries, ice cream)
Cookies with nuts/dry fruit
• If you have diabetes, keep your blood sugar under control.
Uncontrolled blood sugars can change how your stomach
empties food.
Other
• Talk to your doctor or pharmacist about your medications.
Some medications can slow stomach emptying while others can
help to improve your symptoms.
Stage 3: Solid foods low in fat and fibre. Allows you to have a little more
fat than Stage 2, and also limits foods containing a lot of fibre.
Food Group
Milk and
Alternatives
__________________________________________________________________________________
Recommended
Same as Stage 2 plus:
2% MF, homogenized and
chocolate milk
Regular soy, rice, almond milk
Milkshakes
Eggnog
Smoothies
Kefir
Buttermilk
1% or 2% MF cottage cheese
Ice cream
Fat free or 5% MF sour cream
Evaporated milk (0 to 2% MF)
Avoid
Regular cheese with >20% MF
Regular sour cream
Whipping cream (10 or 18% MF)
________________________________________________________________________________
10
Gastroparesis
Food Group
Recommended Items
Gastroparesis
Items to Avoid
Vegetables
Same as Stage 2
Same as Stage 2
Fruits
Peeled fresh fruit such as
banana, apple, pear, peaches,
plums, melons
Apple/cranberry/grape/prune
juice
Canned fruits without skins
(applesauce, peaches, pears,
apricots, mandarin oranges)
All fruits and juices not listed in
items to avoid
Fruits with skins, seeds and
membranes such as: berries,
pineapple, grapes, oranges,
pomegranates
Dried fruit such as coconut, figs,
raisins, prunes, cranberries,
apricots, currants, dates
Citrus juices with pulp
Canned fruits with skin such as
cherries
Avocado
Same as Stage 2
Grains and
Starches
Same as Stage 2
Egg and ramen noodles
Meat and
Alternatives
Eggs/egg whites
Smooth peanut butter (maximum
2 tablespoons a day)
Poultry with no skin
Fish, shellfish
Lean beef
Pork
Low fat deli meats
Extra lean ground beef
Lean ground chicken/turkey
Canned fish in water
Low fat deli meats
Preparation: bake, broil, poach,
BBQ
Fats and Oils
Any type of fat but in small
quantities
Spray oils
Fat free gravy
Low fat mayonnaise
Fibrous meats
Steaks
Roasts
Bacon
Sausage
Bologna, salami
Hot dogs
Goose
Duck
Spare ribs
Organ meats
Fish packed in oil
Crunchy peanut butter
Dried beans and peas
Lentils
Nuts and seeds
European frankfurters and other
deli-made wieners/sausages with
tough casings
Deep fried meats
None
__________________________________________________________________________________
3
How is gastroparesis treated?
• Taking medication to help:
o Food move through your stomach
o Reduce nausea and vomiting
• Changing your diet to help improve your symptoms and prevent
poor nutrition.
• Controlling your blood sugar levels if you have diabetes.
What diet and lifestyle changes can I make to help control
my symptoms?
To help improve your symptoms of gastroparesis:
• Eat 6 or more small meals a day. Larger meals take longer to
digest and can make you feel full very quickly
• Chew foods well. This helps your stomach digest food better.
Avoid foods that are not easily chewed such as broccoli, corn,
popcorn, nuts and seeds.
• Eat healthy foods first. Choose foods with lots of nutrients
before filling up on “empty calories” such as tea, coffee, water,
pop and candies.
• Avoid lying down after a meal. Stay sitting up for at least one
hour after your meal. Going for a walk after your meal can also
help the food move through your stomach faster.
• Choose foods that are lower in fibre. Fibre is not digested and
can stay in the stomach longer, slowing digestion. Fibre can also
make you feel more full, making it difficult to eat enough food to
get all of the nutrients you need. Cooking fruits and vegetables
until soft can help you to digest them.
________________________________________________________________________________
2
Gastroparesis
What are the symptoms of gastroparesis?
Your symptoms may include:
•
•
•
•
•
a feeling of fullness after a few bites
belching or burping
bloating or abdominal distension
nausea and vomiting
food or fluid from the stomach moving back into your mouth
– this is called regurgitation or heartburn
• decreased appetite which may lead to weight loss and poor
nutrition
• constipation
Food Group
Beverages
Soups
Sweets
Other
If you have diabetes, you may also have abnormal sugar (glucose)
levels in your blood.
What are the complications of gastroparesis?
Complications of gastroparesis could include:
•
•
•
•
•
•
•
•
weight loss
abdominal discomfort
bacterial overgrowth
food that stays in the stomach too long can start to ferment,
causing bacteria to grow
bezoar
o A bezoar is a mixture of food residues/materials that can
accumulate or build up in the stomach and does not
empty well. A bezoar can block food from going into the
small intestine.
blood sugar fluctuations
o For people with diabetes, blood sugars may be harder to
control as food is digested at inconsistent times.
dehydration (not enough fluid in your body)
electrolyte imbalance
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11
Gastroparesis
Recommended Items
Gatorade/soft drinks (small
amounts at a time)
Flavoured coffee
Tea
Hot chocolate
Water, lemonade, Kool-Aid
Nutritional supplements
Same as Stage 2 plus all soups
made with all milks
Same as Stage 2 plus:
Angel food cake
Low fat cookies such as
arrowroot, social tea, graham
crackers
Same as Stage 2
Items to Avoid
Alcohol
All others not listed in
recommended items
Soups made with cream
Broths containing fat
Same as Stage 2
What do I do if my symptoms get worse?
• Try drinking nutritional supplements and pureed foods before you
take liquids with small amounts of nutrients, like coffee, tea and pop.
• On days when your symptoms are worse, rest your stomach by taking
fluids or pureed foods only (this does not have to be as strict as
stage 1 of the gastroparesis diet, see list below). Small portions
(around 1 cup) or having sips through out the day may help you to
better tolerate them.
List of fluids and pureed foods:
• Broth, cream or pureed soups
• Juice (apple, cranberry, grape, prune)
• Sprite, gingerale
• Tomato juice/V8
• Milk
• Eggnog
• Kefir
• Yogurt
• Milkshakes, pudding, smoothies and custards
• Baby food
• Oral rehydration solutions, such as: Gastrolyte or Pedialyte
• Powerade/Gatorade
please turn over 
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12
Gastroparesis
• Nutritional Supplements such as:
o Carnation Breakfast Anytime
o Boost
o Boost Diabetic
o Boost Fruit Beverage
o Boost High Protein
o
o
o
o
o
Boost Plus Calories
Ensure
Ensure High Protein
Ensure Plus
Glucerna
How can I puree or “blenderize” my foods?
Pureed foods can sometimes be easier for your body to digest. Refer to the
HHS “Pureed Diet” handout to learn about how to blenderize your foods.
Gastroparesis
What is gastroparesis (gas-tro-pear-ee-sis)?
Sample diet
The following is a sample diet for someone who is following stage 3
of the Gastroparesis Diet.
• Breakfast: 1 cup cream of wheat, 1 slice white toast and 1 tablespoon
peanut butter, ½ cup skim milk, ½ cup juice
• Snack: 6 ounces low fat yogurt and ½ banana or 1 cup nutritional
supplement
• Lunch: 1 cup pasta, 1 tablespoon fat-free parmesan cheese and
1 tablespoon low fat margarine, ½ cup applesauce, ½ cup skim milk
or 4 ounces nutritional supplement
Or
½ turkey sandwich with 1 Tbsp low fat mayonnaise with ½ cup
chicken noodle soup, ½ cup applesauce, ½ cup skim milk
• Snack: ½ cup canned peaches and ¼ cup low-fat cottage cheese
Or
smoothie with ½ cup Gatorade or carbonated beverage
• Dinner: 2 ounces skinless chicken or fish, ½ cup cooked squash
and ½ cup cooked mashed potatoes with no skin, 1 tsp butter,
½ cup skim milk, ½ cup canned peaches
• Snack: 1 cup low-fat pudding or frozen yogurt, ½ cup carbonated
beverage
• Liquids: vegetable juice, crystal light, water, fruit juice, skim or
1% milk
©
Hamilton Health Sciences, 2013
PD 8364 – 11/2013
dpc/pted/Gastroparesis-trh.doc
dt/November 12, 2013
Gastroparesis is a condition where food moves through your stomach
slower than normal and takes longer to digest (breakdown).
What causes gastroparesis?
The cause of gastroparesis is not always clear, but it is believed that
there might be damage to a nerve that controls stomach muscles.
It can occur suddenly or as a result of:
• diabetes
• stomach surgery or nerve injury such as after bariatric gastric
surgery
• medications, such as narcotics
o ask your doctor if any of your medications slow down
stomach emptying
• nervous system diseases like Parkinson’s Disease,
Multiple Sclerosis, or Amyotrophic Lateral Sclerosis (ALS)
• infection, such as viral gastroenteritis
• certain cancer treatments
• collagen vascular disorders such as scleroderma
• lupus
• hypothyroidism
• gastroesophageal reflux disease
____________________________________________________________________________
How do I read a food label?
Reading the Nutrition Facts table is the best way to find out how much fat and
fibre a food has. Below is a Nutrition Facts table for Rice Krispies Cereal.
The amount listed is for the
serving size given.
Remember,
foods lower in fat and fibre might be
easier for you to tolerate.
Nutrition Facts
Per 1 cup (28 g)
Amount
% Daily Value
Calories 110
Fat 0 g
0%
Saturated 0 g
+ Trans 0 g
0%
Cholesterol 0 mg
0%
Sodium 190 mg
8%
Carbohydrate 25g
8%
Fibre 0 g
0%
Sugars 3 g
Protein 2 g
Vitamin A
0%
Vitamin C
0%
©
Hamilton Health Sciences, 2013
PD 8364 – 11/2013
dpc/pted/GastroparesisINSERT-trh.doc
dt/November 12, 2013